Toxic retinopathy secondary to repeat intravitreal amikacin and vancomycin

Ne, Habib; Ty, Malik; Gm, Dawidex; Nj, Price; Mp, Headon

doi:10.1038/eye.1994.175

Cited by 1 publication

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References 6 publications

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“…Multiple injections of vancomycin with gentamicin or vancomycin with amikacin have been associated with retinal toxicities; however, prolonged infection can also cause severe inflammation and permanent ocular damage. 24, 25 There was no chorioretinopathy directly attributed to repeated intravitreal antibiotics in the current series.…”

Section: Discussionmentioning

confidence: 48%

Persistently Vitreous Culture–Positive Exogenous Bacterial Endophthalmitis

Leung

Kuriyan

Flynn

et al. 2016

American Journal of Ophthalmology

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Purpose To report the clinical settings, bacterial isolates, antibiotic sensitivities, and visual outcomes of patients with persistently positive vitreous cultures after intravitreal antibiotics. Design Consecutive, non-comparative case series. Methods Setting Tertiary care center Patient Population 29 eyes of 29 patients with exogenous endophthalmitis with the same bacterial organism identified on at least two consecutive vitreous cultures Observation Procedures Vitreous culture with intravitreal injection of antibiotics and pars plana vitrectomy with intravitreal antibiotics Main Outcome Measures Bacterial isolates, antibiotic sensitivities, visual outcomes Results Twenty-nine eyes of 29 patients met the study criteria. The mean follow-up was 28.7 months. The most common clinical settings were after cataract extraction (15/29, 51%) and glaucoma surgery (9/29, 31%). The mean initial visual acuity was 2.21 ± 0.74 logMAR (Snellen equivalent ≈20/3200), and there was no statistically significant change at the final evaluation (1.98 ± 1.1 logMAR, ≈20/1900, P = 0.32). The most common bacteria were Staphylococcus (10/29, 34%) and Streptococcus (7/29, 24%). Gram-positive bacteria were sensitive to vancomycin (22/22, 100%); Gram-negative bacteria were sensitive to amikacin (3/3, 100%). The antibiotic sensitivities were the same on repeat cultures in 25 of 27 patients (93%). The initial treatment was a vitreous tap and intravitreal injection of antibiotics in 22 of 29 patients (76%). The vision at the last follow-up was 20/200 or better in 11 patients (38%) and no light perception in 10 of 29 patients (34%). Conclusions The most commonly identified organisms in the current series were Gram-positive bacteria. There was good concordance in the antibiotic sensitivities between initial and subsequent cultures. Patients with persistently vitreous culture-positive endophthalmitis had poor visual outcomes.

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Section: Discussionmentioning

confidence: 48%